目的 探讨输尿管镜钬激光碎石术治疗糖尿病肾盏结石的效果及对术后尿路炎症的影响。方法 选取2021-01-01至2023-03-31武警北京总队医院收治的行输尿管镜钬激光碎石术治疗的肾盏结石患者124例,根据是否合并糖尿病分为A组62例(合并糖尿病)和B组62例(不合并糖尿病)。观察两组治疗指标及治疗前后血清、尿液中的炎症因子表达情况。结果 两组手术时间[(75.6±8.7)min vs. (73.8±12.8)min]和结石清除率(80.6% vs. 82.3%)比较,差异无统计学意义;B组住院时间(4.1±0.8)d,术中出血量(12.4±3.9)ml,显著低于A组[(6.6±1.2)d、(15.2±5.8)ml],差异有统计学意义(P<0.05)。两组手术后12 h血清IL-1β、IL-6和CRP表达量显著高于手术前,且B组明显低于A组,差异有统计学意义(P<0.05)。两组手术后12 h尿液中IL-1β、IL-6和CRP表达量显著高于手术前,且B组显著低于A组,差异具有统计学意义(P<0.05)。结论 合并有糖尿病的肾盏结石患者行输尿管镜钬激光碎石术后要积极抗炎治疗,避免影响手术结果。
Abstract
Objective To investigate the effect of ureteroscopic holmium laser lithotripsy in the treatment of diabetic renal calyceal stones and its influence on postoperative inflammation of urinary tract.Methods A total of 124 patients with renal calyceal stones treated with ureteroscopic holmium laser lithotripsy admitted to Beijing Municipal Corps Hospital of Chinese People's Armed Police Force from January 2021 to March 2023 were selected and divided into group A (with diabetes, n=62) and group B (without diabetes, n=62) according to whether they were combined with diabetes. The therapeutic indexes and the expression of inflammatory factors in serum and urine before and after treatment in the two groups were observed.Results Compared with the operation time (75.6±8.7 vs. 73.8±12.8) min and stone removal rate (80.6% vs. 82.3%) of patients in the two groups, the differences were not statistically significant; however, the length of hospitalization in group B was (4.1±0.8) d, and the amount of intraoperative blood loss was (12.4±3.9) ml, which was significantly lower than that in group A [(6.6±1.2) d, (15.2±5.8) ml], and the difference was statistically significant (P<0.05). The expressions of serum IL-1β, IL-6 and CRP in the two groups at 12 h after operation were significantly higher than those before surgery, and those in group B were significantly lower than those in group A, with statistically significant (P<0.05). The expressions of IL-1β, IL-6 and CRP in urine at 12 h after surgery were significantly higher than those before surgery in both groups, and those in group B were significantly lower than those in group A, with statistically significant (P<0.05).Conclusions Active anti-inflammatory therapy should be applied to ureteroscopic holmium laser lithotripsy in patients with renal calyceal stones combined with diabetes mellitus to avoid affecting the surgical results.
关键词
输尿管镜 /
狄激光碎石术 /
糖尿病肾盏结石 /
尿路炎症
Key words
ureteroscopy /
holmium laser lithotripsy /
diabetic calyceal stone /
urinary tract inflammation
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